According to a recent study a widely prescribed drug for breast cancer, known as alpelisib or Piqray, may lead to a significant risk of high blood sugar (hyperglycemia) in breast cancer patients.
Alpelisib causes high blood sugar in patients
Alpelisib has been developed with the aim of specifically addressing the phosphoinositide 3-kinase (PI3K) protein, which plays a significant role in regulating cell growth. In cases where PI3K undergoes mutations, it can contribute to the advancement of cancer. Acknowledging its promising therapeutic potential, the U.S. Food and Drug Administration (FDA) granted approval in 2019 for the utilization of alpelisib in conjunction with fulvestrant, an estrogen receptor inhibitor, to treat specific occurrences of metastatic breast cancer linked to PI3K gene mutations.
Nonetheless, there is a potential drawback. The utilization of alpelisib to target PI3K may lead to an undesirable consequence: the onset of hyperglycemia. In its acute form, hyperglycemia has the potential to induce significant issues, such as severe dehydration or kidney impairment, at times requiring hospitalization.
High initial haemoglobin A1c levels a risk factor
Researchers from Memorial Sloan Kettering Cancer Center investigated hyperglycemia associated with alpelisib treatment in metastatic breast cancer patients, both in standard care and clinical trials.
Their findings revealed that 80.3% of 147 patients receiving standard care with alpelisib experienced hyperglycemia, with 40.2% having severe cases. Among 100 clinical trial participants, 34% encountered some level of hyperglycemia, including 13% with severe forms. On average, hyperglycemia appeared 16 days after alpelisib treatment. High initial hemoglobin A1c levels were identified as a significant risk factor, indicating elevated blood sugar levels akin to pre-diabetes or diabetes.
About 66.4% of individuals dealing with high blood sugar received treatment, often using the diabetes medication metformin.
According to Dr. Sherry Shen from Memorial Sloan Kettering Cancer Center to prevent hyperglycemia when treating patients with a PI3KCA mutation using alpelisib, it is crucial to check their hemoglobin A1c levels and collaborate with their primary care physician or endocrinologist to optimize blood sugar levels. This should be done several months before starting alpelisib treatment because hyperglycemia typically occurs within the first two weeks of treatment.
